World Neurosurg
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Spontaneous intracranial hypotension (SIH) is a well-known, but under- or misdiagnosed, condition caused by cerebrospinal fluid leak resulting from idiopathic dural breach. Blind lumbar epidural blood patch is an effective treatment in most cases, but occasionally, even targeted epidural blood patch fails to lead to improvement. In these cases, the cerebrospinal fluid leak is usually repaired surgically, especially for large dural breaches (>5 mm), once the site has been identified by imaging techniques (magnetic resonance myelography/computed tomography [CT] myelography/isotopic transit). ⋯ We report 2 cases with good technical and clinical outcome after 1 and 8 years of follow-up (clinical evaluation and brain imaging control by CT). The technique we describe here is of high interest in refractory SIH or for the serious form of the disease, before considering surgical repair. Further prospective studies are required to provide general guidelines in treatment options for patients with SIH.
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Brain cognitive functions affect patient quality of life. The frontal lobe plays a crucial role in advanced cognitive functions, including executive function, meta-cognition, decision-making, memory, emotion, and language. Therefore, frontal tumors can lead to serious cognitive impairments. ⋯ The treatment may both resolve the effects of the tumor to improve cognitive function or cause permanent disabilities resulting from damage to healthy functional brain tissue. Previous studies have focused on the influence of frontal lesions and surgical treatments on patient cognitive function. Here, we review cognitive impairment caused by frontal lobe brain tumors.
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Comparative Study
Lvis stent versus Enterprise stent for the Treatment of Unruptured Intracranial Aneurysms.
This retrospective study compared clinical and angiographic outcomes between LVIS and Enterprise stents. ⋯ Compared with Enterprise stents, LVIS stents may achieve greater complete or near-complete occlusion rate. There was no significant difference in procedural-related complications and clinical outcomes between LVIS and Enterprise stents.
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Medical complications severely impair recovery of neurosurgical patients after craniotomy. The purpose of this study was to identify patients at risk of peri- and postoperative medical complications. Therefore, we present a large population of patients with different medical complications after elective craniotomy. ⋯ In this study, we identified predictors that help characterize patients at risk of medical complications after elective neurosurgical procedures. These correlations should be taken into account when advising patients on craniotomy.
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Multicenter Study
Implementing routine head circumference (HC) measurements in Addis Ababa, Ethiopia - means and challenges.
A substantial number of infants in Ethiopia suffer from hydrocephalus. Neurosurgical expertise has until recently been virtually nonexistent in the country; however, since 2006, a neurosurgery training program has been established in Addis Ababa, where hydrocephalus surgery now is performed in 3 hospitals. Our experience is that hydrocephalus is diagnosed and treatment is too late to avoid severe brain damage. Introducing routine head circumference (HC) measurements can ease the detection of hydrocephalus and thus lead to earlier diagnosis, thereby reducing the brain damage caused by the condition. The present pilot project had two major aims: to get the process of implementation started and to gain experience with how this implementation best can be achieved. ⋯ The experience we have gained during this pilot project will be used in further development and implementation of routine HC measuring throughout Ethiopia. These experiences may be of interest and use to others wanting to introduce similar routines in low-income countries.